PDF(Pubmed)
Abstract：
UNASSIGNED: The main objective of this study was to determine whether myocardial strain and myocardial work are altered in hypertension and whether the strain is independent of hypertension-induced left ventricular hypertrophy.
UNASSIGNED: Two systematic literature searches were conducted using Medline and EMBASE through to June 30, 2022. In the first, search terms left ventricular strain or speckle tracking AND hypertension and left ventricular hypertrophy were used in conjunction with Boolean operators to identify articles reporting left ventricular strain in patients with hypertension. In the second, the terms Global cardiac or myocardial work AND hypertension were used to identify articles. Publication bias was assessed by examination of funnel plots and calculation of the Failsafe N and Duval and Tweedie\'s Trim and fill. The results were presented as Forrest plots.
UNASSIGNED: Global longitudinal strain (GLS) was significantly lower in patients with hypertension compared to those without hypertension with a mean difference of 2.0 ± 0.1 (standard error of mean(SEM)) in the fixed effect model. Global circumferential strain (GCS) was significantly lower in hypertension. The mean difference between the hypertensive and non-hypertensive groups was 1.37 ± 0.17. Global radial strain (GRS) was significantly (p < 0.05) greater in hypertension. However, this difference was significant in only 3 and of borderline significance in 3 of 14 studies where GRS was measured. The mean difference between the hypertensive and non-hypertensive groups was 1.5 ± 0.5 using the fixed effects model. There was a significant relationship between GLS and GCS as well as between GCS and GRS but no significant relationship between GLS and GRS. There was no significant difference in left ventricular ejection fraction (LVEF) between the hypertension and no hypertension groups. There was no significant relationship between LVEF and either GLS or GCS but a significant negative correlation was found between LVEF and GRS. GLS was further reduced in persons with hypertension and left ventricular hypertrophy (LVH) compared to hypertension without LVH. In contrast, there were no or minimal differences in GCS and GRS for individuals with hypertension and LVH compared to those without LVH. Global myocardial work index (GWI) and Global constructive work (GCW) were significantly greater in patients with hypertension compared to controls. Global wasted work (GWW) indicated significantly less wasted work in controls compared to hypertension. In contrast, Global work efficiency (GWE) was significantly lower in hypertension compared to the control.
UNASSIGNED: There was a significant reduction in GLS and GCS in hypertension while GRS was increased. The reduction in GLS in hypertension was not dependent on the presence of LVH. GLS was further reduced in persons with hypertension when LVH was present. In contrast, there were no or minimal differences in GCS and GRS for individuals with LVH compared to those without LVH. GLS was independent of left ventricle (LV) ejection fraction. GWI, GCW and GWW were greater in hypertension while GWE was lower in hypertension compared to controls. These data support the contention that GLS and indices of global work are early markers of hypertensive heart disease.
UNASSIGNED: Two systematic literature searches were conducted using Medline and EMBASE through to June 30, 2022. In the first, search terms left ventricular strain or speckle tracking AND hypertension and left ventricular hypertrophy were used in conjunction with Boolean operators to identify articles reporting left ventricular strain in patients with hypertension. In the second, the terms Global cardiac or myocardial work AND hypertension were used to identify articles. Publication bias was assessed by examination of funnel plots and calculation of the Failsafe N and Duval and Tweedie\'s Trim and fill. The results were presented as Forrest plots.
UNASSIGNED: Global longitudinal strain (GLS) was significantly lower in patients with hypertension compared to those without hypertension with a mean difference of 2.0 ± 0.1 (standard error of mean(SEM)) in the fixed effect model. Global circumferential strain (GCS) was significantly lower in hypertension. The mean difference between the hypertensive and non-hypertensive groups was 1.37 ± 0.17. Global radial strain (GRS) was significantly (p < 0.05) greater in hypertension. However, this difference was significant in only 3 and of borderline significance in 3 of 14 studies where GRS was measured. The mean difference between the hypertensive and non-hypertensive groups was 1.5 ± 0.5 using the fixed effects model. There was a significant relationship between GLS and GCS as well as between GCS and GRS but no significant relationship between GLS and GRS. There was no significant difference in left ventricular ejection fraction (LVEF) between the hypertension and no hypertension groups. There was no significant relationship between LVEF and either GLS or GCS but a significant negative correlation was found between LVEF and GRS. GLS was further reduced in persons with hypertension and left ventricular hypertrophy (LVH) compared to hypertension without LVH. In contrast, there were no or minimal differences in GCS and GRS for individuals with hypertension and LVH compared to those without LVH. Global myocardial work index (GWI) and Global constructive work (GCW) were significantly greater in patients with hypertension compared to controls. Global wasted work (GWW) indicated significantly less wasted work in controls compared to hypertension. In contrast, Global work efficiency (GWE) was significantly lower in hypertension compared to the control.
UNASSIGNED: There was a significant reduction in GLS and GCS in hypertension while GRS was increased. The reduction in GLS in hypertension was not dependent on the presence of LVH. GLS was further reduced in persons with hypertension when LVH was present. In contrast, there were no or minimal differences in GCS and GRS for individuals with LVH compared to those without LVH. GLS was independent of left ventricle (LV) ejection fraction. GWI, GCW and GWW were greater in hypertension while GWE was lower in hypertension compared to controls. These data support the contention that GLS and indices of global work are early markers of hypertensive heart disease.
摘要：
■这项研究的主要目的是确定高血压患者的心肌劳损和心肌劳损是否改变，以及该劳损是否与高血压引起的左心室肥大无关。
■使用Medline和EMBASE进行了两次系统的文献检索，直至2022年6月30日。在第一,搜索词左心室应变或斑点追踪和高血压和左心室肥厚与布尔运算符结合使用,以识别报告高血压患者左心室应变的文章.在第二个，术语“全球心脏或心肌工作和高血压”用于识别文章.通过检查漏斗图以及计算FailsafeN和Duval和Tweedie的修剪和填充来评估发布偏差。结果以福雷斯特图表示。
■在固定效应模型中，与没有高血压的患者相比，高血压患者的整体纵向应变（GLS）显着降低，平均差为2.0±0.1（平均值标准误差（SEM））。高血压患者的整体周向应变（GCS）显着降低。高血压组和非高血压组之间的平均差异为1.37±0.17。高血压患者的整体径向应变（GRS）显着（p<0.05）更大。然而,这一差异仅在3项有显著性,在14项GRS测量研究中的3项具有临界显著性.使用固定效应模型，高血压组和非高血压组之间的平均差异为1.5±0.5。GLS和GCS之间以及GCS和GRS之间存在显着关系，但GLS和GRS之间没有显着关系。高血压组和非高血压组之间的左心室射血分数（LVEF）无明显差别。LVEF与GLS或GCS之间没有显着关系，但LVEF与GRS之间存在显着负相关。与没有LVH的高血压相比，患有高血压和左心室肥大（LVH）的人的GLS进一步降低。相比之下,高血压和LVH患者与无LVH患者相比,GCS和GRS无差异或差异极小.与对照组相比，高血压患者的全球心肌工作指数（GWI）和全球建设性工作（GCW）明显更高。与高血压相比，全球浪费的工作（GWW）表明对照组的浪费工作明显减少。相比之下,与对照组相比，高血压患者的整体工作效率（GWE）显着降低。
■高血压患者GLS和GCS显著降低，而GRS升高。高血压中GLS的降低不依赖于LVH的存在。当存在LVH时，高血压患者的GLS进一步降低。相比之下,与无LVH患者相比,有LVH患者的GCS和GRS无差异或差异极小.GLS独立于左心室（LV）射血分数。GWI,与对照组相比，高血压患者的GCW和GWW更高，而高血压患者的GWE更低。这些数据支持GLS和全球工作指标是高血压心脏病的早期标志的论点。
■使用Medline和EMBASE进行了两次系统的文献检索，直至2022年6月30日。在第一,搜索词左心室应变或斑点追踪和高血压和左心室肥厚与布尔运算符结合使用,以识别报告高血压患者左心室应变的文章.在第二个，术语“全球心脏或心肌工作和高血压”用于识别文章.通过检查漏斗图以及计算FailsafeN和Duval和Tweedie的修剪和填充来评估发布偏差。结果以福雷斯特图表示。
■在固定效应模型中，与没有高血压的患者相比，高血压患者的整体纵向应变（GLS）显着降低，平均差为2.0±0.1（平均值标准误差（SEM））。高血压患者的整体周向应变（GCS）显着降低。高血压组和非高血压组之间的平均差异为1.37±0.17。高血压患者的整体径向应变（GRS）显着（p<0.05）更大。然而,这一差异仅在3项有显著性,在14项GRS测量研究中的3项具有临界显著性.使用固定效应模型，高血压组和非高血压组之间的平均差异为1.5±0.5。GLS和GCS之间以及GCS和GRS之间存在显着关系，但GLS和GRS之间没有显着关系。高血压组和非高血压组之间的左心室射血分数（LVEF）无明显差别。LVEF与GLS或GCS之间没有显着关系，但LVEF与GRS之间存在显着负相关。与没有LVH的高血压相比，患有高血压和左心室肥大（LVH）的人的GLS进一步降低。相比之下,高血压和LVH患者与无LVH患者相比,GCS和GRS无差异或差异极小.与对照组相比，高血压患者的全球心肌工作指数（GWI）和全球建设性工作（GCW）明显更高。与高血压相比，全球浪费的工作（GWW）表明对照组的浪费工作明显减少。相比之下,与对照组相比，高血压患者的整体工作效率（GWE）显着降低。
■高血压患者GLS和GCS显著降低，而GRS升高。高血压中GLS的降低不依赖于LVH的存在。当存在LVH时，高血压患者的GLS进一步降低。相比之下,与无LVH患者相比,有LVH患者的GCS和GRS无差异或差异极小.GLS独立于左心室（LV）射血分数。GWI,与对照组相比，高血压患者的GCW和GWW更高，而高血压患者的GWE更低。这些数据支持GLS和全球工作指标是高血压心脏病的早期标志的论点。
